# CHANGE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FMC SBHC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912311705
- **Authorized official:** JUDY RAVEAUX (CEO)
- **Authorized official phone:** (304) 797-7733

## Contact information

- **Practice address:** 3248 PENNSYLVANIA AVE, WEIRTON, WV 26062-3804
- **Practice address phone:** (304) 748-2828
- **Mailing address:** 3248 PENNSYLVANIA AVE, WEIRTON, WV 26062-3804
- **Mailing address phone:** (304) 748-2828

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2014
- **Last updated:** 06/19/2014